Fill and Sign the Mwcc Form B31 Fill Online Printable Fillable Blankpdffiller

BEFORE THE MISSISSIPPI WORKERS' COMPENSATION COMMISSION **** CLAIMANT VS. MWCC NO. 91 12646-E-6979 **** EMPLOYER/CARRIER CLAIMANT'S SECOND SUPPLEMENTAL RESPONSES TO EMPLOYER AND CARRIER'S FIRST SET OF INTERROGATORIES AND REQUESTS FOR PRODUCTION OF DOCUMENTS COMES NOW the Claimant, ****, by and through her attorney, ****, and files this her Second Supplemental Responses to Employer and Carrier's First Set of Interrogatories and Requests for Production of Documents, to wit: Interrogatory No. 16: Please describe your employment history since the accident(s) which is the subject matter of this claim, such description to include the name and address of each employer for whom you have worked, the dates of each such employment, your pay rate, your job title, and a description of the work activities performed by you. RESPONSE: On December 7, 1992, I returned to work full-time for the employer herein in Building 49 at $859.21/gross wages per month. See attached copy of pay statement. Interrogatory No. 25: Please state the name and address of each and every expert witness, including medical experts, you intend to call as a witness in this cause, and state the substance of the facts and opinions to which each such expert is expected to testify and a summary of the grounds for each opinion. RESPONSE: ****, my treating physician, **** will testify via probability, the accident of July 29, 1991, caused the injury to my right upper extremity. He will further testify that he assigned me a thirty percent (30%) medical impairment rating to my right upper extremity and prescribed restrictions as to future employment. Request for Production No. 1: Please produce copies of any and all medical reports and records in your possession, care, custody or control, concerning any examinations or treatments received by you as a result of the injuries/medical conditions, for which claim is being made herein. RESPONSE: See medical reports on file with the Commission and attached copies. Request for Production No. 4: In the event you have been employed since the accident which is the subject matter of this claim, please produce a wage statement from each employer by whom you have been employed which includes the gross wages paid to you during each week of such employment and the number of days worked per week for each such payment. RESPONSE: Attached. Respectfully submitted, **** STATE OF MISSISSIPPI COUNTY OF HINDS PERSONALLY APPEARED BEFORE ME, the undersigned authority in and for the jurisdiction aforesaid, the within named **** who, after being by me first duly sworn, stated on oath that the matters and things set forth herein are true and correct as therein stated. SWORN TO AND SUBSCRIBED BEFORE ME, this the 5th day of February, 199_. **** NOTARY PUBLIC My Commission Expires: PREPARED, SUBMITTED AS TO OBJECTIONS: **** CERTIFICATE OF SERVICE I, the undersigned attorney, do hereby certify that I hear this date mailed by United States mail, postage prepaid, a true and correct copy of the above and foregoing pleading(s) to: ****